Rabies is a viral infection which is usually transmitted following contact with the saliva of an infected animal most often via a bite, scratch or lick to an open wound or mucous membrane (such as on the eye, nose or mouth). Although many different animals can transmit the virus, worldwide most cases follow a bite or scratch from an infected dog. Bats are also an important source of infection in some countries.
Rabies symptoms can take some time to develop, but when they do the condition is almost always fatal.
The risk of exposure is increased by certain activities and length of stay (see below). Children are at increased risk as they are less likely to avoid contact with animals and to report a bite, scratch or lick.
Rabies in Spain
- There is risk of rabies in the African territories of Ceuta and Melila in Spain.
- Rabies has not been reported in domestic or wild animals in the rest of Spain; therefore most travellers are considered to be at low risk. However, bats may carry bat lyssavirus (bat rabies).
- Travellers to the African territories of Ceuta and Melila should avoid contact with animals.
- For other areas in Spain travellers should avoid contact with bats. Bites from bats are frequently unrecognised. Rabies-like disease caused by bat lyssaviruses is preventable with prompt post-exposure rabies treatment.
- Following a possible exposure, wounds should be thoroughly cleansed and an urgent local medical assessment sought, even if the wound appears trivial.
- Although rabies has not been reported in other animals in the rest of Spain, it is sensible to seek prompt medical advice if bitten or scratched. It is possible, although very rare for bats to pass rabies like viruses to other animals including pets.
Post-exposure treatment and advice should be in accordance with national guidelines.
For travellers to the African territories of Ceuta and Melila:
Pre-exposure vaccinations are recommended for travellers whose activities put them at increased risk including:
- those at risk due to their work (e.g. laboratory staff working with the virus, those working with animals or health workers who may be caring for infected patients).
- those travelling to areas where access to post-exposure treatment and medical care is limited.
- those planning higher risk activities such as running or cycling.
- long-stay travellers (more than one month).
For those travelling to other areas in Spain:
- Pre-exposure rabies vaccinations are recommended for those who are at increased risk due to their work (e.g. laboratory staff working with the virus and those working with bats).
- Pre exposure vaccines could be considered for those whose activities put them at increased risk of exposure to bats.
A full course of pre-exposure vaccines simplifies and shortens the course of post-exposure treatment and removes the need for rabies immunoglobulin which is in short supply world-wide.
Rabies in brief
There have been increased numbers of Hepatitis A cases in England, mainly affecting men who have sex with men. Many of these men have reported travel to Spain, where there has recently been a reported increase in hepatitis A among men.
Hepatitis A is a viral infection of the liver spread by a virus present in the faeces of an infected person. It is transmitted through infected faeces contaminating food and water or by direct contact with an infectious person including sexual transmission.
Hepatitis A is not usually life-threatening but severity can increase with age. Most people make a full recovery within a couple of months . Following hepatitis A illness, immunity is lifelong. Gay and bisexual men with multiple partners are particularly at risk.
Hepatitis A vaccination
High risk men who have sex with men with multiple partners may benefit from vaccination and should seek advice from their sexual health or travel clinic prior to travelling.